Method for the treatment of gallstones

Abstract

There is provided a method for controlling the movement of bile and/or gall stones in the biliary duct. The method comprises gently constricting (i.e., without substantially hampering the blood circulation in the tissue wall) at least one portion of the tissue wall to influence the movement of bile and/or gallstones in the biliary duct, and stimulating the constricted wall portion to cause contraction of the wall portion to further influence the movement of bile and/or gallstones in the biliary duct. The method can be used for restricting or stopping the movement of bile and/or gallstones in the biliary duct, or for actively moving the fluid in the biliary duct, with a low risk of injuring the biliary duct.

What is claimed is: 
     
       1. A method for controlling the movement of bile and/or gallstones in a patient's biliary duct, the method comprising:
 (a) gently constricting at least one portion of the tissue wall of the patient's biliary duct to influence the movement of bile and/or gallstones in the biliary duct, using a constriction device positioned on the outside of the patient's bilary duct, and 
 (b) stimulating at least one portion of the tissue wall of the patient's biliary duct to cause contraction of the wall portion to influence the movement of bile and/or gallstones in the biliary duct, using a stimulation device. 
 
     
     
       2. The method according to  claim 1 , wherein the wall portion is constricted, so that the movement of bile and/or gallstones in the biliary duct is at least is restricted and the constricted wall portion is stimulated to at least further restrict the movement of bile and/or gallstones in the biliary duct. 
     
     
       3. The method according to  claim 2 , wherein the wall portion is constricted to a constricted state, in which the blood circulation in the constricted wall portion is substantially unrestricted and the movement of bile and/or gallstones in the biliary duct is at least restricted, and the constricted wall portion is stimulated when it is in the constricted state to at least further restrict the movement of bile and/or gallstones in the biliary duct. 
     
     
       4. The method according to  claim 2 , wherein the wall portion is stimulated while the constriction of the wall portion is changed. 
     
     
       5. The method according to  claim 1 , wherein the constriction of the wall portion is calibrated by stimulating the wall portion while adjusting the constriction of the wall portion until the desired restriction of the movement of bile and/or gallstones in the biliary duct is obtained. 
     
     
       6. The method according to  claim 1 , wherein step (b) is not performed while step (a) is performed. 
     
     
       7. The method according to  claim 1 , wherein step (a) is performed by constricting the wall portion, so that the movement of bile and/or gallstones in the biliary duct is restricted but not stopped, and step (b) is performed by stimulating the constricted wall portion to cause contraction thereof, so that the movement of bile and/or gallstones in the biliary duct is further restricted but not stopped. 
     
     
       8. The method according to  claim 7 , further comprising sensing a physical parameter of the patient and adjusting the intensity of the stimulation of the wall portion in response to the sensed parameter. 
     
     
       9. The method according to  claim 7 , further comprising (c) ceaseing stimulating the wall portion to increase the movement of bile and/or gallstones in the biliary duct, and (d) releasing the wall portion to restore the movement of bile and/or gallstones in the biliary duct. 
     
     
       10. The method according to  claim 1 , wherein step (a) is performed by constricting the wall portion, so that the movement of bile and/or gallstones in the biliary duct is restricted but not stopped, and step (b) is performed by stimulating the constricted wall portion to cause contraction thereof, so that the movement of bile and/or gallstones in the biliary duct is stopped. 
     
     
       11. The method according to  claim 10 , further comprising (c) ceaseing stimulating the wall portion to allow movement of bile and/or gallstones in the biliary duct, and (d) releasing the wall portion to restore the movement of bile and/or gallstones in the biliary duct. 
     
     
       12. The method according to  claim 10 , further comprising sensing a physical parameter of the patient and adjusting the intensity of the stimulation of the wall portion in response to the sensed parameter, wherein the intensity of the stimulation of the wall portion is increased so that the movement of bile and/or gallstones in the biliary duct remains stopped when a pressure increase occurs in the biliary duct, wherein the physical parameter relates to the pressure in the biliary duct and the stimulation of the wall portion is controlled in response to the sensed parameter, and wherein the physical parameter is a pressure in the patient's body. 
     
     
       13. The method according to  claim 1 , wherein step (a) is performed by constricting the wall portion, so that the movement of bile and/or gallstones in the biliary duct is stopped. 
     
     
       14. The method according to  claim 13 , further comprising (c) releasing the wall portion to restore the movement of bile and/or gallstones in the biliary duct. 
     
     
       15. The method according to  claim 13 , wherein step (b) is performed by stimulating the constricted wall portion to cause contraction thereof, so that the movement of bile and/or gallstones in the biliary duct remains stopped when a pressure increase occurs in the biliary duct, further comprising sensing a physical parameter of the patient's that relates to the pressure in the biliary duct, and controlling the stimulation of the wall portion in response to the sensed parameter, wherein the physical parameter is a pressure in the patient's body. 
     
     
       16. The method according to  claim 1 , wherein steps (a) and (b) are co-operated to move the bile and/or gall stones in the biliary duct. 
     
     
       17. The method according to  claim 16 , wherein step (a) is performed by constricting the wall portion to restrict the movement of bile and/or gallstones in the biliary duct, and step (b) is performed by progressively stimulating the constricted wall portion to cause progressive contraction of the wall portion to move the bile and/or gall stones in the biliary duct, and wherein the constricted wall portion is progressively stimulated in the downstream or upstream direction of the biliary duct. 
     
     
       18. The method according to  claim 16 , wherein step (a) is performed by constricting the wall portion to restrict the movement of bile and/or gallstones in the biliary duct, and step (b) is performed by stimulating the constricted wall portion to close the biliary duct either at an upstream end or a downstream end of the constricted wall portion, further comprising (c) increasing the constriction of the wall portion to move the bile and/or gallstones in the biliary duct. 
     
     
       19. The method according to  claim 16 , wherein step (a) is performed by varyingly constricting the wall portion to vary the movement of bile and/or gallstones in the biliary duct, and step (b) is performed by progressively stimulating the constricted wall portion to cause progressive contraction of the wall portion to move the bile and/or gallstones in the biliary duct, and wherein the constricted wall portion is progressively stimulated in the downstream or upstream direction of the biliary duct. 
     
     
       20. The method according to  claim 16 , wherein step (a) is performed by varyingly constricting different areas of the wall portion to cause progressive constriction of the wall portion in the downstream or upstream direction of the biliary duct. 
     
     
       21. The method according to  claim 20 , wherein the constricted wall portion is progressively stimulated to cause progressive contraction thereof in harmony with the progressive constriction of the wall portion. 
     
     
       22. The method according to  claim 20 , further comprising providing at least one elongated constriction element extending along the wall portion, and controlling the elongated constriction element to progressively constrict the wall portion in the downstream or upstream direction of the biliary duct, wherein the elongated constriction element comprises contact surfaces dimensioned to contact a length of the wall portion, further comprising providing a plurality of stimulation elements distributed along the contact surfaces, and controlling the stimulation elements to stimulate the different areas of the wall portion along the length of the wall portion. 
     
     
       23. The method according to  claim 16 , wherein step (a) is performed by constricting any one of a series of wall portions of the tissue wall to at least restrict the movement of bile and/or gallstones in the biliary duct, and step (b) is performed by stimulating the constricted wall portion to close the biliary duct, further comprising successively constricting the wall portions of the series of wall portions to move the bile and/or gallstones in the biliary duct in a peristaltic manner. 
     
     
       24. The method according to  claim 23 , further comprising providing at least one constriction element and at least one stimulation element positioned on the constriction element, moving the constriction element along the biliary duct to successively constrict the wall portions of the series of wall portions, and using the stimulation element to stimulate the wall portion constricted by the constriction element to close the biliary duct, and further comprising cyclically moving the constriction element along the wall portions of the series of wall portions. 
     
     
       25. The method according to  claim 23 , further comprising providing a plurality of constriction elements and stimulation elements positioned on the constriction elements, moving each constriction element along the biliary duct to successively constrict the wall portions of the series of wall portions, and using the stimulation elements to stimulate the wall portion constricted by any one of the constriction elements to close the biliary duct, further comprising cyclically moving the constriction elements one after the other along the wall portions of the series of wall portions, and further comprising providing a rotor carrying the constriction elements, and rotating the rotor so that each constriction element cyclically constricts the wall portions of the series of wall portions, wherein each constriction element comprises a roller that rolls on the biliary duct to constrict the latter. 
     
     
       26. The method according to  claim 16 , wherein step (a) is performed by constricting the wall portion at an upstream or downstream end thereof to close the biliary duct, further comprising (c) constricting the wall portion between the upstream and downstream ends thereof, to move the fluid or other bodily matter contained in the wall portion between the upstream and downstream ends thereof downstream or upstream in the biliary duct, further comprising stimulating the wall portion between the upstream and downstream ends thereof, as step (c) is performed, wherein step (a) is performed by constricting the wall portion at the upstream or downstream end thereof to restrict the movement of bile and/or gallstones in the biliary duct, and step (b) is performed by stimulating the constricted wall portion at the upstream or downstream end to close the biliary duct, whereby the bile and/or gallstones contained in the wall portion between the upstream and downstream ends thereof is moved downstream or upstream in the biliary duct, as step (c) is performed. 
     
     
       27. The method according to  claim 16 , wherein step (b) is performed by stimulating the wall portion with electric pulses. 
     
     
       28. The method according to  claim 1 , further comprising controlling by the patient the constriction and/or stimulation of the wall portion from outside the patient's body. 
     
     
       29. The method according to  claim 1 , further comprising sensing a physical parameter of the patient and automatically controlling the constriction and/or stimulation of the wall portion in response to the sensed parameter. 
     
     
       30. The method according to  claim 1 , further comprising providing a constriction device for performing step (a) and a stimulation device for performing step (b), and forming the constriction and stimulation devices in an operable constriction/stimulation unit. 
     
     
       31. The method according to  claim 30 , further comprising providing a control device that controls the constriction/stimulation unit, and operating the control device from outside the patient's body. 
     
     
       32. The method according to  claim 31 , wherein the control device comprises a hand-held wireless remote control, or a manually operable switch for switching on and off the constriction device, stimulation device, constriction and stimulation device, or operable constriction/stimulation unit, the method further comprising using the switch when subcutaneously implanted in the patient and manually operating the implanted switch from outside the patient's body. 
     
     
       33. The method according to  claim 31 , further comprising using the control device to wirelessly control the constriction device and/or stimulation device in a non-magnetic manner. 
     
     
       34. The method according to  claim 31 , wherein the control device comprises a manually operable switch for switching on and off the constriction/stimulation unit, further using the switch subcutaneously implanted in the patient. 
     
     
       35. The method according to  claim 31 , wherein the control device comprises a wireless remote control that controls the constriction/stimulation unit from outside the patient's body, wherein the wireless remote control transmits at least one wireless control signal for controlling the constriction/stimulation unit. 
     
     
       36. The method according to  claim 35 , wherein the control signal comprises a frequency, amplitude, phase modulated signal or a combination thereof, and an analogue or a digital signal, or a combination of an analogue and digital signal. 
     
     
       37. The method according to  claim 36 , wherein the wireless remote control transmits an electromagnetic carrier wave signal that carries the digital or analogue control signal. 
     
     
       38. The method according to  claim 35 , wherein the wireless remote control transmits a carrier signal that carries the control signal, the carrier signal comprising digital, analogue or a combination of digital and analogue wave signals. 
     
     
       39. The method according to  claim 35 , wherein the control signal comprises an electric or magnetic field or a combined electric and magnetic field, or a wave signal comprising one of a sound wave signal, an ultrasound wave signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, an ultra violet light signal, a laser light signal, a micro wave signal, a radio wave signal, an x-ray radiation signal and a gamma radiation signal. 
     
     
       40. The method according to  claim 30 , further comprising calibrating the constriction of the wall portion by controlling the stimulation device to stimulate the wall portion while controlling the constriction device to adjust the constriction of the wall portion until the desired restriction of the movement of bile and/or gallstones in the biliary duct is obtained. 
     
     
       41. The method according to  claim 30 , further comprising implanting at least one sensor and controlling by the control device the constriction device and/or stimulation device in response to signals from the sensor. 
     
     
       42. The method according to  claim 41 , wherein at least one physical parameter of the patient is directly or indirectly sensed by the sensor, the sensor comprising a pressure sensor that senses a pressure in the patient's body, further comprising controlling the constriction device by the control device to change the constriction of the patient's wall portion in response to the pressure sensor sensing a predetermined value. 
     
     
       43. The method according to  claim 41 , further comprising implanting in the patient a medical implant, wherein at least one functional parameter of the medical implant is directly or indirectly sensed by the sensor. 
     
     
       44. The method according to  claim 41 , wherein the control device comprises an internal control unit, further comprising implanting in the patient the internal control unit and directly controlling by the internal control unit the constriction device and/or stimulation device in response to signals from the sensor. 
     
     
       45. The method according to  claim 41 , wherein the control device comprises an external control unit outside the patient's body, further comprising controlling by the external control unit the constriction device and/or stimulation device in response to signals from the sensor. 
     
     
       46. The method according to  claim 41 , wherein the control device produces an indication in response to signals from the sensor, the indication comprising a sound signal or displayed information. 
     
     
       47. The method according to  claim 30 , further comprising transmitting wireless energy from outside the patient's body to inside the patient's body and using the transmitted wireless energy in connection with the operation of the constriction/stimulation unit. 
     
     
       48. The method according to  claim 47 , further comprising directly using the wireless energy in connection with the operation of the constriction/stimulation unit as the wireless energy is being transmitted, wherein the wireless energy comprises an electric, an electromagnetic or a magnetic field, or a combination thereof, or electromagnetic waves, and further comprising implanting in the patient an electric motor or pump operatively connected to the constriction device and directly powering the motor or pump by wireless energy in the form of a magnetic or an electromagnetic field. 
     
     
       49. The method according to  claim 47 , wherein the wireless energy comprises energy of a first form, further comprising transmitting the energy of the first form into energy of a second form and operating the constriction/stimulation unit with the energy of the second form. 
     
     
       50. The method according to  claim 49 , wherein the energy of the second form is different than the energy of the first form, the energy of the second form comprises electric energy and the constriction/stimulation unit is directly operated with the energy of the second form in a non-magnetic, non-thermal or non-mechanical manner. 
     
     
       51. The method according to  claim 49 , wherein the energy of the first form is directly or indirectly transformed into the energy of the second form, further comprising providing a motor for operating the constriction device and powering the motor with the energy of the second form. 
     
     
       52. The method according to  claim 51 , wherein the constriction device is operable to perform at least one reversible function, further comprising reversing the function by using the motor. 
     
     
       53. The method according to  claim 51 , further comprising shifting polarity of the energy of the second form to reverse the motor. 
     
     
       54. The method according to  claim 51 , further comprising directly powering the motor with the transformed energy of the second form, as the energy of the second form is being transformed from the energy of the first form. 
     
     
       55. The method according to  claim 49 , wherein the wireless energy of the first form comprises sound waves and the energy of the second form comprises electric energy. 
     
     
       56. The method according to  claim 49 , further comprising implanting in the patient a source of energy for storing the energy of the second form and supplying energy from the source of energy in connection with the operation of the constriction/stimulation unit, wherein the source of energy comprises an accumulator, and wherein the accumulator comprises at least one capacitor or at least one rechargeable battery, or a combination of at least one capacitor and at least one rechargeable battery. 
     
     
       57. The method according to  claim 49 , further comprising implanting in the patient a source of energy for supplying energy for the operation of the constriction/stimulation unit and a switch for switching the energy supplied by the source of energy, and using the energy of the second form to operate the switch to switch from an “off” mode, in which the source of energy is not in use, to an “on” mode, in which the source of energy supplies energy for the operation of the constriction/stimulation unit. 
     
     
       58. The method according to  claim 49 , further comprising implanting in the patient a stabilizer for stabilizing the energy of the second form, wherein the energy of the second form comprises electric current and the stabilizer comprises at least one capacitor. 
     
     
       59. The method according to  claim 49 , wherein the energy of the first form comprises an electric, an electromagnetic or a magnetic field, or a combination thereof. 
     
     
       60. The method according to  claim 49 , wherein the energy of the first form is transformed into a direct current or pulsating direct current, or a combination of a direct current and pulsating direct current, or transformed into an alternating current or a combination of a direct and alternating current. 
     
     
       61. The method according to  claim 49 , wherein one of the energy of the first form and the energy of the second form comprises magnetic energy, kinetic energy, sound energy, chemical energy, radiant energy, electromagnetic energy, photo energy, nuclear energy or thermal energy. 
     
     
       62. The method according to  claim 49 , wherein one of the energy of the first form and the energy of the second form is non-magnetic, non-kinetic, non-chemical, non-sonic, non-nuclear or non-thermal. 
     
     
       63. The method according to  claim 47 , wherein the wireless energy is transmitted in at least one wireless signal. 
     
     
       64. The method according to  claim 63 , wherein the signal comprises a wave signal in the form of a sound or ultrasound wave signal, or in the form of an electromagnetic wave signal including one of an infrared light signal, a visible light signal, an ultra violet light signal, a laser signal, a micro wave signal, a radio wave signal, an x-ray radiation signal, and a gamma radiation signal. 
     
     
       65. The method according to  claim 63 , wherein the signal comprises a digital or analogue signal, or a combination of a digital and analogue signal. 
     
     
       66. The method according to  claim 47 , wherein the wireless energy comprises an electric, an electromagnetic or a magnetic field, or a combination thereof, further comprising transmitting the wireless energy in pulses or digital pulses, or a combination of pulses and digital pulses. 
     
     
       67. The method according to  claim 30 , further comprising implanting in the patient an operation device and operating the constriction/stimulation unit with the operation device. 
     
     
       68. The method according to  claim 67 , further comprising providing a magnet and activating the operation device with the magnet, wherein the magnet activates the operation device from outside the patient's body. 
     
     
       69. The method according to  claim 67 , wherein the operation device comprises a motor, further comprising providing a source of energy and powering the motor with energy released from the source of energy. 
     
     
       70. The method according to  claim 30 , further comprising implanting a source of energy, releasing energy from the source of energy and using the released energy in connection with the operation of the constriction/stimulation unit, wherein the source of energy comprises a battery. 
     
     
       71. The method according to  claim 1 , wherein step (b) is performed by intermittently and individually stimulating different areas of the wall portion so that at least two of the areas are stimulated at different points of time, wherein step (b) is performed by intermittently stimulating each area of the different areas of the wall portion during successive time periods, each time period being short enough to maintain over time satisfactory blood circulation in the area until the laps of the time period, and wherein step (b) is performed by intermittently stimulating the areas of the wall portion so that an area of the wall portion that currently is not stimulated has time to restore substantially normal blood circulation before it is stimulated again. 
     
     
       72. The method according to  claim 1 , wherein step (b) is performed by stimulating one or more of different areas of the wall portion at a time. 
     
     
       73. The method according to  claim 72 , wherein step (b) is performed by sequentially stimulating the different areas of the wall portion, or by shifting the stimulation from one area to another over time, or by cyclically propagating the stimulation of the areas along the wall portion in the same or opposite direction of the flow in the patient's biliary duct in accordance with a determined stimulation pattern. 
     
     
       74. The method according to  claim 1 , wherein step (b) is performed by stimulating the wall portion with cyclically varying stimulation intensity. 
     
     
       75. The method according to  claim 1 , wherein the stimulation step is performed by intermittently and individually stimulating different areas of the wall portion with pulses. 
     
     
       76. The method according to  claim 1 , wherein the pulses form pulse trains and at least one of the following steps is performed:
 varying the pulse amplitudes of the pulses of the pulse trains; 
 varying the frequency of the pulses of the pulse trains; 
 varying the frequency of the pulse trains; and 
 varying the number of pulses of each pulse train. 
 
     
     
       77. The method according to  claim 75 , wherein the pulses form pulse trains and at least one of the following steps is performed:
 varying the off time periods between the individual pulses of each pulse train; 
 varying the off time periods between the pulse trains; 
 varying the width of each pulse of the pulse trains; and 
 varying the length of each pulse train. 
 
     
     
       78. The method according to  claim 75 , wherein the pulses form pulse trains and each off time period between the pulse trains is kept long enough to restore substantially normal blood circulation in each area when the area is not stimulated during the off time periods. 
     
     
       79. The method according to  claim 1 , wherein step (b) is performed by electrically stimulating different areas of the wall portion with electric pulses. 
     
     
       80. The method according to  claim 79 , wherein the wall portion includes muscle fibers, and step (b) is performed by stimulating the wall portion including the muscle fibers with the electric pulses. 
     
     
       81. The method according to  claim 79 , further comprising providing at least one electrical element engaging the wall portion. 
     
     
       82. The method according to  claim 81 , further comprising providing a plurality of electrical elements engaging the wall portion. 
     
     
       83. The method according to  claim 82 , further comprising placing the electrical elements in a fixed orientation relative to one another and providing a structure holding the electrical elements in the fixed orientation, wherein the electrical elements form an elongate pattern of electrical elements with two opposite short ends, and further comprising applying the structure on the patient's biliary duct so that the elongate pattern of electrical elements extends along the wall portion of the biliary duct in the direction of the flow in the patient's biliary duct and the elements abut the respective areas of the wall portion. 
     
     
       84. The method according to  claim 82 , further comprising electrically energizing the electrical elements, wherein each electrical element is cyclically energized with electric pulses. 
     
     
       85. The method according to  claim 84 , wherein the electrical elements are energized so that a number or groups of the electrical elements are energized at the same time. 
     
     
       86. The method according to  claim 84 , wherein the electrical elements are energized one at a time in sequence or groups of the electrical elements are sequentially energized, either randomly or in accordance with a predetermined pattern. 
     
     
       87. The method according to  claim 84 , further comprising applying the electrical elements on the patient's biliary duct so that the electrical elements form an elongate pattern of electrical elements extending along the wall portion of the biliary duct in the direction of the flow in the patient's biliary duct and the elements abut the respective areas of the wall portion. 
     
     
       88. The method according to  claim 87 , wherein the electrical elements are successively energized along the elongate pattern of electrical elements. 
     
     
       89. The method according to  claim 88 , wherein the electrical elements are successively energized along the elongate pattern of electrical elements in the same or opposite direction of the flow in the patient's biliary duct. 
     
     
       90. The method according to  claim 88 , wherein the electrical elements are successively energized along the elongate pattern of electrical elements from a position substantially at the center of the constricted wall portion towards both ends of the elongate pattern of electrical elements. 
     
     
       91. The method according to  claim 88 , wherein the electrical elements are energized so that electrical elements currently energized form at least one group of adjacent energized electrical elements. 
     
     
       92. The method according to  claim 91 , wherein the elements in the group of energized electrical elements form a path of energized electrical elements, and wherein the path of energized electrical elements extends at least in part or completely around the patient's biliary duct. 
     
     
       93. The method according to  claim 91 , wherein the group of adjacent energized electrical elements comprises one or more electrical elements. 
     
     
       94. The method according to  claim 93 , wherein the group of adjacent energized electrical elements comprises two electrical elements provided mutually on opposite sides of the patient's bilary duct. 
     
     
       95. The method according to  claim 93 , wherein the group of adjacent energized electrical elements comprises three electrical elements extending around the patient's bilary duct. 
     
     
       96. The method according to  claim 91 , wherein the electrical elements are applied on the patient's bilary duct in a series of groups of elements extending along the patient's bilary duct in the direction of flow in the patient's bilary duct, and wherein the groups of electrical elements in the series of groups are successively energized in the same or opposite direction of the flow in the patient's bilary duct. 
     
     
       97. The method according to  claim 87 , wherein the electrical elements are applied on the patient's biliary duct in a series of groups of elements extending along the patient's biliary duct in the direction of flow in the patient's biliary duct. 
     
     
       98. The method according to  claim 97 , wherein the groups of electrical elements in the series of groups are successively energized in the same or opposite direction to that of the flow in the patient's biliary duct. 
     
     
       99. The method according to  claim 97 , wherein the electrical elements of each group of electrical elements form a path of elements extending at least in part or completely around the patient's biliary duct. 
     
     
       100. The method according to  claim 97 , wherein the electrical elements of each group of electrical elements form two paths of elements extending on mutual sides of the patient's biliary duct, and wherein the two paths of electrical elements of each group of elements extend at least substantially transverse to the direction of flow in the patient's bilary duct. 
     
     
       101. The method according to  claim 1 , wherein step (b) is performed by thermally stimulating the wall portion, allowing to at different time periods;
 stimulating by cooling, the wall portion when gently constricting the wall portion to influence the movement of bile and/or gallstones in the biliary duct, and 
 releasing the wall portion to restore the movement of bile and/or gallstones in the biliary duct, and 
 ceaseing stimulating the wall portion to increase the movement of bile and/or gallstones in the biliary duct, and instead 
 stimulating by heating the wall portion to further allow the movement of gallstones in the biliary duct. 
 
     
     
       102. The method according to  claim 101 , wherein step (a) is performed to at least influence the movement of bile and/or gallstones in the biliary duct, and step (b) is performed by cooling the wall portion to cause contraction of the wall portion, so that the movement of bile and/or gallstones in the biliary duct is at least further influenced. 
     
     
       103. The method according to  claim 102 , wherein the step of heating the wall portion, is performed to cause expansion of the wall portion. 
     
     
       104. The method according to  claim 101 , wherein the method steps are co-operated to move the bile and/or gall stones in the biliary duct. 
     
     
       105. The method according to  claim 104 , wherein step (a) is performed by varyingly constricting the wall portion to vary the movement of bile and/or gallstones in the biliary duct, and step (b) is performed by progressively stimulating the constricted wall portion to cause progressive contraction of the wall portion to move the bile and/or gallstones in the biliary duct, and wherein the constricted wall portion is progressively stimulated in the downstream or upstream direction of the biliary duct. 
     
     
       106. The method according to  claim 104 , wherein step (a) is performed by varyingly constricting different areas of the wall portion to cause progressive constriction of the wall portion in the downstream or upstream direction of the biliary duct. 
     
     
       107. The method according to  claim 106 , wherein the constricted wall portion is progressively stimulated to cause progressive contraction thereof in harmony with the progressive constriction of the wall portion. 
     
     
       108. The method according to  claim 104 , wherein step (a) is performed by constricting any one of a series of wall portions of the tissue wall to at least restrict the movement of bile and/or gallstones in the biliary duct, and step (b) is performed by stimulating the constricted wall portion to successively constricting the wall portions of the series of wall portions to move the bile and/or gallstones in the biliary duct in a peristaltic manner. 
     
     
       109. A method according to  claim 101 , placing the constriction device and the stimulation device, the method comprising the steps of:
 inserting a needle like tube into the abdomen of the patient's body, 
 using the needle like tube to fill the abdomen with gas thereby expanding the abdominal cavity, 
 placing at least two laparoscopical trocars in the patient's body, 
 inserting a camera through one of the trocars into the abdomen, 
 inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of the tissue wall of the biliary duct, 
 placing a constriction device and a stimulation device in the dissected area in operative engagement with the biliary duct. 
 
     
     
       110. The method according to  claim 1 , wherein step (a) is performed by mechanically or hydraulically constricting the wall portion. 
     
     
       111. The method according to  claim 110 , wherein step (a) is performed by mechanically or hydraulically constricting the wall portion in a non-magnetic and/or non-manual manner. 
     
     
       112. The method according to  claim 110 , wherein step (a) is performed by constricting the wall portion so that the through-flow area of the biliary duct assumes a size in the constricted state small enough to cause the movement of bile and/or gallstones in the biliary duct to stop when step (b) is performed. 
     
     
       113. The method according to  claim 110 , wherein step (a) is performed by bending the biliary duct, or clamping the biliary duct between at least two elements positioned on different sides of the biliary duct, or clamping the biliary duct between an element and the bone or tissue of the patient, or rotating at least two elements positioned on different sides of the biliary duct, or clamping the biliary duct between at least two articulated clamping elements positioned on different sides of the biliary duct. 
     
     
       114. The method according to  claim 110 , further comprising implanting in the patient a main reservoir containing a predetermined amount of hydraulic fluid and a constriction device engaging the wall portion and having an expandable cavity, wherein step (a) is performed by distributing hydraulic fluid from the main reservoir to increase the volume of the cavity to constrict the wall portion. 
     
     
       115. The method according to  claim 114 , wherein the main reservoir comprises first and second wall portions, and step (a) is performed by displacing the first and second wall portions towards each other to decrease the volume of the main reservoir, so that fluid is distributed from the main reservoir to the cavity. 
     
     
       116. The method according to  claim 114 , further comprising implanting a reverse servo that distributes hydraulic fluid from the main reservoir to the cavity. 
     
     
       117. The method according to  claim 116 , wherein the main reservoir comprises first and second wall portions, and the reverse servo displaces the first and second wall portions towards each other to decrease the volume of the main reservoir, so that fluid is distributed from the main reservoir to the cavity, and wherein the reverse servo comprises an expandable servo reservoir containing servo fluid and having first and second wall portions, which are displaceable relative to each other in response to a change in the volume of the expandable servo reservoir, and the first and second wall portions of the servo reservoir are operatively connected to the first and second wall portions of the main reservoir, so that the volume of the main reservoir is changed when the volume of the servo reservoir is changed. 
     
     
       118. The method according to  claim 117 , wherein the first and second wall portions of the servo reservoir are displaced relative to each other by manual manipulation or by a magnetic device, a hydraulic device, or an electric control device. 
     
     
       119. The method according to  claim 117 , further comprising dimensioning the servo and main reservoirs so that when the volume of the servo reservoir is changed by a relatively small amount of servo fluid, the volume of the main reservoir is changed by a relatively large amount of hydraulic fluid. 
     
     
       120. The method according to  claim 117 , wherein the reverse servo comprises a fluid supply reservoir hydraulically connected to the servo reservoir to form a closed conduit system for the servo fluid. 
     
     
       121. The method according to  claim 114 , further comprising implanting in the patient a pump that pumps fluid between the main reservoir and the cavity. 
     
     
       122. The method according to  claim 121 , wherein the pump comprises a first activation member that activates the pump to pump fluid from the main reservoir to the cavity and a second activation member that activates the pump to pump fluid from the cavity to the main reservoir. 
     
     
       123. The method according to  claim 122  wherein at least one of the activation members operates when subjected to an external predetermined pressure. 
     
     
       124. The method according to  claim 122 , wherein at least one of the first and second activating members are operated by a magnetic device, a hydraulic device, or an electric control device. 
     
     
       125. The method according to  claim 121 , further comprising implanting a fluid conduit between the pump and the cavity, the main reservoir forming part of the conduit and the conduit and pump being devoid of any non-return valve, wherein the main reservoir forms a fluid chamber with a variable volume, step (a) is performed by reducing the volume of the chamber so that fluid is pumped from the chamber to the cavity and the pump comprises a movable wall of the main reservoir for changing the volume of the chamber, the method further comprising implanting a motor for driving the pump. 
     
     
       126. The method according to  claim 1 , further comprising providing a constriction device for performing step (a), a stimulation device for performing step (b) and an external source of energy outside the patient's body, controlling the external source of energy from outside the patient's body to release wireless energy, and using the released wireless energy for operating the constriction device and/or stimulation device. 
     
     
       127. The method according to  claim 126 , further comprising transforming the wireless energy into electrical energy inside the patient's body by an implanted energy-transforming device and using the electrical energy in connection with the operation of the constriction device and/or stimulation device. 
     
     
       128. The method according to  claim 127 , further comprising directly using the electrical energy in connection with the operation of the constriction device and/or stimulation device, as the transforming device transforms the wireless energy into the electrical energy. 
     
     
       129. The method according to  claim 126 , further comprising controlling the external source of energy from outside the patient's body to release non-magnetic wireless energy, and using the released non-magnetic wireless energy for operating the constriction device and/or stimulation device. 
     
     
       130. The method according to  claim 126 , further comprising controlling the external source of energy from outside the patient's body to release electromagnetic wireless energy, and using the released electromagnetic wireless energy for operating the constriction device and/or stimulation device. 
     
     
       131. The method according to  claim 126 , further comprising providing an internal energy source, wherein the wireless energy is transmitted from the external energy source located outside the patient and is received by the internal energy source located inside the patient, the internal energy source being connected to at least one of the constriction and stimulation devices for directly or indirectly supplying received energy thereto, the method further comprising the steps of:
 determining an energy balance between the energy received by the internal energy source and the energy used for at least one of the constriction and stimulation devices, and 
 controlling the transmission of wireless energy from the external energy source, based on the determined energy balance. 
 
     
     
       132. The method according to  claim 131 , wherein the wireless energy is transmitted inductively from a primary coil in the external energy source to a secondary coil in the internal energy source. 
     
     
       133. The method according to  claim 131 , wherein a change in the energy balance is detected, and the transmission of wireless energy is controlled based on the detected energy balance change. 
     
     
       134. The method according to  claim 133 , wherein the amount of transmitted wireless energy is decreased if the detected energy balance change implies that the energy balance is increasing, or vice versa, wherein the decrease/increase of energy transmission corresponds to a detected change rate. 
     
     
       135. The method according to  claim 133 , wherein the energy used for at least one of the constriction and stimulation devices is stored in at least one energy storage device of the device. 
     
     
       136. The method according to  claim 133 , wherein substantially all the energy used for at least one of the constriction and stimulation devices is consumed to operate the device, wherein the energy is consumed after being stabilised in at least one energy stabilising unit of the device. 
     
     
       137. The method according to  claim 131 , wherein a difference is detected between energy received by the internal energy source and energy used for the constriction device and/or stimulation device, and the transmission of wireless energy is controlled based on said detected energy difference, and wherein the amount of transmitted wireless energy is decreased if the detected energy difference implies that the received energy is greater than the used energy, or vice versa, wherein the decrease/increase of energy transmission corresponds to the magnitude of the detected energy difference. 
     
     
       138. The method according to  claim 137 , wherein the energy used for at least one of the constriction and stimulation devices is stored in at least one energy storage device of the device. 
     
     
       139. The method according to  claim 137 , wherein substantially all the energy used for at least one of the constriction and stimulation devices is consumed to operate the device, wherein the energy is consumed after being stabilised in at least one energy stabilising unit of the device. 
     
     
       140. The method according to  claim 1 , wherein step (a) is performed by constricting any wall portions of a series of wall portions of the biliary duct's tissue wall, respectively. 
     
     
       141. The method according to  claim 140 , wherein the wall portions of the series of wall portions are constricted in random or in accordance with a predetermined sequence, further comprising constricting the wall portions of the series of wall portions at least two at a time at positions spaced apart on the biliary duct. 
     
     
       142. The method according to  claim 140 , wherein the wall portions of the series of wall portions are successively constricted along the biliary duct to move the bile and/or gall stones in the biliary duct. 
     
     
       143. The method according to  claim 140 , wherein step (b) is performed by stimulating any constricted wall portions of the series of wall portions. 
     
     
       144. The method according to  claim 143 , wherein the wall portions of the series of wall portions are constricted in random or in accordance with a predetermined sequence, further comprising constricting the wall portions of the series of wall portions at least two at a time at positions spaced apart on the biliary duct. 
     
     
       145. The method according to  claim 143 , wherein the wall portions of the series of wall portions are successively constricted along the biliary duct to move bile and/or gallstones biliary duct or to prevent bile and/or gallstones from moving in the biliary duct. 
     
     
       146. The method according to  claim 140 , wherein the wall portions of the series of wall portions are constricted without completely closing the biliary duct, and step (b) is performed by stimulating the constricted wall portions one after the other, so that the wall portions of the series of wall portions are successively contracted along the biliary duct to move the bile and/or gall stones in the biliary duct. 
     
     
       147. The method according to  claim 146 , wherein the wall portions of the series of wall portions are constricted in random or in accordance with a predetermined sequence, further comprising constricting the wall portions of the series of wall portions at least two at a time at positions spaced apart on the biliary duct. 
     
     
       148. The method according to  claim 140 , wherein the wall portions of the series of wall portions are successively constricted along the biliary duct to move bile and/or gallstones in the biliary duct or to prevent the bile and/or gallstones from moving in biliary duct, further comprising constricting the wall portions of the series of wall portions at least two at a time at positions spaced apart on the biliary duct to move the bile and/or gallstones in the biliary duct or to prevent the bile and/or gallstones from moving in the biliary duct. 
     
     
       149. The method according to  claim 1 , wherein the stimulation step is performed by stimulating any constricted wall portions of a series of wall portions. 
     
     
       150. The method according to  claim 149 , wherein the wall portions of the series of wall portions are constricted by a stimulation device in random or in accordance with a predetermined sequence. 
     
     
       151. The method according to  claim 140 , wherein step (a) is performed by constricting all of the wall portions of the series of wall portions, and step (b) is performed by stimulating any constricted wall portions in random or in accordance with a predetermined sequence to close the biliary duct. 
     
     
       152. The method according to  claim 151 , wherein the wall portions of the series of wall portions are further constricted by the stimulation device in random or in accordance with a predetermined sequence, further comprising constricting the wall portions of the series of wall portions at least two at a time at positions spaced apart on the biliary duct. 
     
     
       153. The method according to  claim 151 , wherein the wall portions of the series of wall portions are successively further constricted by the stimulation device along the biliary ductto move bile and/or gallstones in the biliary duct or to prevent the bile and/or gallstones from moving in the biliary duct. 
     
     
       154. The method according to  claim 126 , further comprising providing an internal energy source located inside the patient connected to at least one of the constriction and stimulation devices for directly or indirectly supplying received energy thereto, the method comprising the steps of:
 determining an energy balance between the energy sent by the external energy source and the energy received by the internal energy source, and 
 controlling the transmission of wireless energy from the external energy source, based on the determined energy balance. 
 
     
     
       155. The method according to  claim 154 , wherein the wireless energy is transmitted inductively from a primary coil in the external energy source to a secondary coil in the internal energy source. 
     
     
       156. The method according to  claim 154 , wherein a change in the energy balance is detected, and the transmission of wireless energy is controlled based on the detected energy balance change. 
     
     
       157. The method according to  claim 156 , wherein the amount of transmitted wireless energy is decreased if the detected energy balance change implies that the energy balance is increasing, or vice versa, wherein the decrease/increase of energy transmission corresponds to a detected change rate. 
     
     
       158. The method according to  claim 154 , wherein a difference is detected between the energy sent by the external energy source and the energy received by the internal energy source, and the transmission of wireless energy is controlled based on the detected energy difference. 
     
     
       159. The method according to  claim 158 , wherein the amount of transmitted wireless energy is decreased if the detected energy difference implies that the received energy is greater than the used energy, or vice versa, wherein the decrease/increase of energy transmission corresponds to the magnitude of the detected energy difference. 
     
     
       160. The method according to  claim 154 , wherein the wireless energy is transmitted by means of a primary coil in the external energy source and received inductively by means of a secondary coil in an internal energy source, the internal energy source is connected to a device for directly or indirectly supplying received energy thereto, and wherein feedback control information is transferred from the secondary coil to the primary coil by switching the secondary coil on and off to induce a detectable impedance load variation in the primary coil encoding the feedback control information, and wherein the feedback control information relates to the energy received by the internal energy source and is used for controlling the transmission of wireless energy from the external energy source. 
     
     
       161. The method according to  claim 160 , wherein the external energy source further comprises an electronic circuit for comparing the feedback information with the amount of energy transmitted by the external energy source, wherein the electronic circuit comprises an analyzer, further comprising analyzing by the analyzer the amount of energy being transmitted and the received feedback information related to the amount of energy received in the receiver, and determining the energy balance by comparing the amount of transmitted energy and the feedback information related to the amount of received energy, further comprising using the feedback information to adjust the level of the energy transmitted from the external energy source. 
     
     
       162. The method according to  claim 131 , wherein the wireless energy is transmitted by means of a primary coil in the external energy source and received inductively by means of a secondary coil in the internal energy source, wherein feedback control information is transferred from the secondary coil to the primary coil by switching the secondary coil on and off to induce a detectable impedance load variation in the primary coil encoding the feedback control information, where the feedback control information relates to the energy balance. 
     
     
       163. The method according to  claim 126 , further comprising the steps of;
 transmitting wireless energy from a coil of the external energy source placed externally to the human body, 
 placing an implantable energy receiver internally in the human body, 
 providing an electric circuit connected to the external coil, the coil, 
 supplying by the external coil electrical pulses to transmit the wireless energy, the electrical pulses having leading and trailing edges, 
 varying first time intervals between successive leading and trailing edges and/or second time intervals between successive trailing and leading edges of the electrical pulses, thus varying the power of the transmitted wireless energy, 
 receiving by the energy receiver the transmitted wireless energy having a varied power. 
 
     
     
       164. The method according to  claim 163 , further comprising delivering by the electric circuit the electrical pulses to remain unchanged except varying the first and/or second time intervals. 
     
     
       165. The method according to  claim 163 , wherein the electric circuit has a time constant, further comprising
 varying the first and second time intervals only in the range of the first time constant, so that when the lengths of the first and/or second time intervals are varied the transmitted power over the coil is varied. 
 
     
     
       166. The method according to  claim 1 , wherein step (a) and step (b) are performed simultaneously or independently of each other. 
     
     
       167. A method according to  claim 1  using the constriction device and the stimulation device, the method comprising the steps of:
 inserting a needle like tube into the abdomen of the patient's body, 
 using the needle like tube to fill the abdomen with gas thereby expanding the abdominal cavity, 
 placing at least two laparoscopical trocars in the patient's body, 
 inserting a camera through one of the trocars into the abdomen, 
 inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of the tissue wall of the biliary duct, 
 placing a constriction device and a stimulation device in the dissected area in operative engagement with the biliary duct. 
 
     
     
       168. The method according to  claim 167 , wherein the cavity comprising; at least one of an abdominal cavity, a cavity in the pelvic region, a thoraxial cavity, a cavity in a limb, a cavity in human soft tissue, or muscle, or fat or fibrotic tissue. 
     
     
       169. A method according to  claim 1 , using the constriction device and the stimulation device, the method comprising the steps of:
 cutting the skin of the patient, 
 inserting a dissecting tool and dissecting an area of at least one portion of the tissue wall of the biliary duct, 
 placing a flow influence device comprising, a constriction device and a stimulation device in the dissected area in operative engagement with the biliary duct.